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Biomedical subjects

M Kaufman

Publications and source records attributed to M Kaufman.

At least 163 records · Page 9Linked to original sources
PubMed1982

Comparison of the composition of faecal fluid in Crohn's disease and ulcerative colitis.

We determined the ionic composition of faecal fluid from 13 patients with Crohn's disease limited to the colon, 10 with diffuse ulcerative colitis, and eight with ulcerative proctitis. The Crohn's and colitis groups had similar proportions of colon surface involved radiographically and similar 24 hour faecal weights. However, Crohn's patients' faecal fluid had arithmetically lower mean sodium and statistically lower mean chloride (34.8 mmol/l +/- 16.2 SD vs. 53.1 mmol/l +/- 23.1 SD) and higher potassium (49.2 mmol/l +/- 20.2 SD vs. 33.0 mmol/l +/- 13.8 SD) concentrations (p less than 0.05 for each) and much higher osmolality (487.1 mOsmol/kg +/- 87.1 SD vs. 341.1 mOsmol/kg +/- 88.9 SD, p less than 0.001). Separation of these patients using the faecal osmotic gap agreed with the clinical classification in 86% of cases. The diarrhoea of proctitis patients had a nearly normal ionic composition which was clearly distinguishable from that of diffuse colitis. These results suggest differences in the composition and perhaps the pathogenesis of the diarrhoea of Crohn's and ulcerative colitis. The composition of fluid may prove a useful, non-invasive method for classifying patients with inflammatory bowel disease and, in ulcerative colitis, determining the extent of the inflammatory process.

Chlorides↗
PubMed1982

Effects of dexamethasone on antigen expression and virus production in avian sarcoma virus-transformed cells.

We studied the effects of dexamethasone on virus production and antigen expression in avian retrovirus-infected chick embryo fibroblast (CEF) cells. The presence of specific receptors for this hormone in both normal and infected CEF cells could only be demonstrated using cultures that were at or near confluence. Dexamethasone, while not toxic to the cells, exerted a growth-retarding influence when employed at concentrations of 10(-8) or 10(-9) M. These same concentrations of hormone were inhibitory to virus production, elaboration of plasminogen activator activity, and antigen expression as determined in a sensitized lymphocyte stimulation assay. In contrast, infected cells that had been treated with hormone displayed enhanced reactivity in a specific immunofluorescence test.

Alpharetrovirus↗
PubMed1981

Evaluation of internal carotid stenosis with the Chronopulse, an automated ocular pulse arrival time recorder.

The diagnostic value of ocular pulse time measurement with the Chronopulse was evaluated in 67 patients who had carotid arteriography. The diagnostic accuracy of 85.5 percent was comparable to that obtained by two other groups using a different timing device. Identification of bilateral stenosis was the major problem encountered and resulted from measuring the external carotid circulation at the ear. Ocular pneumoplethysmography performed in the same patients yielded a higher diagnostic accuracy than the pulse timing, and combining the two did not enhance the results. Therefore, we recommend that the Chronopulse not be used as part of the routine ocular pneumoplethysmographic examination but that it be reserved for selective application.

Blood Pressure↗
PubMed1981

Quality assurance in ambulatory nutritional care. I. Past, present, and future.

Public health nutritionists have begun to coordinate efforts toward development of national standards for ambulatory nutritional care by writing and field testing criteria for selected target populations of pregnant women, infants, and children. These efforts have identified problems related to the "state of the art" in both quality assurance and nutrition science. This article reviews the literature on quality assurance in nutritional care and summarizes the current efforts culminating in publication of a preliminary guide on quality assurance in ambulatory nutrition care by the U.S. Department of Health and Human Services.

Adolescent↗
PubMed1981

Quality assurance in ambulatory nutritional care. II. Field testing of criteria.

Quality assurance criteria developed for six target populations of pregnant women and obese infants, children, and adolescents were field tested in 102 ambulatory care settings to determine whether they were relevant, understandable, measurable, behavioral, and achievable. Field testing identified specific problems in ambulatory nutritional care settings related to documentation and feasibility of using patient care records to provide data to assess quality of care and to determine how statements were formulated. Field test results were used to rewrite the criteria. Findings are consistent with those of other authors.

Adolescent↗
PubMed1981

Pleuroscopy in clinical evaluation and staging of lung cancer.

The use of pleuroscopy in patients with bronchogenic carcinoma has not been reported previously. We performed this procedure in 45 lung cancer patients in whom pleural involvement was suspected. Pleural fluid or mestastases were found in 37 patients, 5 of whom had also major atelectasis due to bronchial obstruction by tumor. Neoplasm penetrating vital structures (aorta, brachial plexus) was found in 3 patients, tumor confining to resectable structures in 3; no pleural abnormalities were disclosed in 2. Based on these findings, 43 tumors were assigned stage III. Only on two occasions pleuroscopy did not aid staging. In 20 patients with massive pleural effusion causing dyspnea we insufflated talc in order to produce pleurodesis. This was fully successful in 16 patients, while in 2 the pleural cavity became only partially obliterated, with symptomatic relief. In 2 patients pleurodesis could not be evaluated because of early death caused by progression of cancer. Pleuroscopy is a highly informative procedure, applicable when involvement of pleura by lung cancer is suspected. It is helpful in clinical staging of the tumor and in assessment of its resectability, particularly in elderly, poor-risk patients. It provides the best way for talc insufflation when pleurodesis is indicated. Pleuroscopy should have an established place in the clinical evaluation and staging of lung cancer.

Adult↗
PubMed1980

Pleuroscopy in patients with pleural effusion and pleural masses.

We performed diagnostic pleuroscopy in 66 patients with pleural effusion and in 14 with pleural masses. The findings were diagnostic in 76 patients (95%). Pleural metastases were found in 63 patients, primary pleural or lung tumor in 5, and less common findings in the remainder. Only 1 minor complication occurred, and there were no deaths. Malignant pleural effusion causing dyspnea was managed successfully by talc insufflation under direct vision in 31 of 35 patients. Talc also was used with equal success and without complications in management of recurrent pneumothorax. We conclude that pleuroscopy is a useful diagnostic and therapeutic procedure. It is simple and well tolerated, has a diagnostic yield of 95%, and is virtually free from complications. It provides the best way of insufflating talc for pleurodesis.

Adult↗
PubMed1979

Cephalic neurulation and optic vesicle formation in the early mouse embryo.

The overall pattern of cephalic neurulation and the concomitant early development of the optic vesicles in mouse embryos were examined by scanning electron microscopy. Paraffin-sectioned specimens were also examined. The overall pattern of closure of the cephalic neural folds accords well with earlier observations of this process. The earliest indication of optic placode formation was seen in histological sections of embryos at the 4-somite stage, while optic pit formation was first observed at the 5- to 6-somite stage. The upper halves of the optic vesicles were formed in 10- to 15-somite embryos by the fusion of the neural folds at the junction between the mesencephalon and prosencephalon, while closure of the lower halves was associated with the closure of the rostral neuropore, and was usually completed by about the 20-somite stage. By the 25- to 30-somite stage, a rapid increase in the volume of the forebrain was observed, so that the optic vesicles were displaced laterally. An overall increase in the volume of the optic vesicles and decrease in the diameter of the optic stalks were also observed at this time. This account of cephalic neurulation and optic organogenesis provides useful baseline data relevant to the study of the normal early development of the mouse. A comparison is made between similar events in the rat, the hamster, and the human embryo.

Animals↗
PubMed1979

Complete androgen insensitivity with a normal amount of 5 alpha-dihydrotestosterone-binding activity in labium majus skin fibroblasts.

We have studied labium majus skin fibroblast strains from six unrelated, previously unreported, patients with complete androgen insensitivity (CAI). Four have markedly reduced specific 5 alpha-dihydrotestosterone-binding (DHT-binding) activity (receptor-negative). The other two (receptor-positive) have normal activities in whole-cell homogenates, the 100,000g supernatant of cell sonicates prepared in 0.4 MKCl, purified whole nuclei, and the nuclear fraction that resists extraction with 0.4 MKCl. In one of the two, the DHT-binding macromolecules in the cytosol and 0.4 M KCl-extractable nuclear fraction have normal molecular sieving profiles and binding activities. One of the receptor-positive patients has maternally related affected relatives in three successive genetations. Appreciable unexplained interexperimental variation of the DHT-binding activities in genital skin fibroblast strains demands that multiple assays be performed on a strain before its receptor status is classified quantitatively. In our experience to date with genital skin fibroblasts, four of 13 propositi with CAI have been receptor-positive.

Adolescent↗
PubMed1979

Characteristics of the primary lesion of malignant melanoma as a guide to prognosis and therapy.

The histologic materal from the original lesion of 113 patients suffering from Clinical Stage I and Clinical Stage II malignant melanomas were reviewed in an attempt to correlate depth of invasion with prognosis and to test whether or not current methods of microstaging were a valid guide to therapy. Both the microstaging methods of Clark and Breslow were eminently successful in indicating the prognosis of the patient, but were of no greater utility than other histologic parameters such as mitotic activity, perineural, vascular, or lymphatic invasion, or the presence of superficial ulceration. The value of elective node dissection for the treatment of primary malignant melanoma is uncertain. Deterents against empiric dissection are its low yield of occult metastases, its inability to prevent recurrence in a substantial portion of patients independent of the status of the nodes, and the difficulty in demonstrating an improved survival rate when this method of therapy is employed. Neither Clark's nor Breslow's methods or microstaging appeared to yield adequate criteria by which to choose node dissection. A simplified method of microstaging is proposed utilizing well defined anatomic levels, and yields statistically valid criteria for the performance of elective node dissection. Using this method, elective node dissection is advocated solely for those tumors that clearly invade the reticular dermis. Patients with tumors restricted to the papillary dermis do not appear to be benefited by empiric node dissection.

Adolescent↗